You may join or leave a plan only at certain times. Please call Senior Health Plan at the telephone number listed in the previous section of this web page or
1-800-MEDICARE (1-800-633-4227) for more information.
TTY users should call 1-877-486-2048. You can call this number 24 hours a day, seven days a week.
You can join Senior Health Plan if you are entitled to Medicare Part A and enrolled in Medicare Part B and live in the service area.
However, individuals with End Stage Renal Disease are generally not eligible to enroll in Senior Health Plan unless they are members of our organization
and have been since their dialysis began.
Senior Health Plan has formed a network of doctors, specialists, and hospitals. You can only use doctors who are part of our network.
The health providers in our network can change at any time. You can ask for a current Provider Directory for an up-to-date list or search the
Senior Health Plan provider directory on this website. If you choose to go to a doctor outside of our network, you must pay for these services yourself.
Neither Senior Health Plan nor Original Medicare will pay for these services.
You must continue to pay your Medicare Part B premium, even if the Senior Health Plan premium is $0.
Senior Health Plan has formed a network of pharmacies. You must use a network pharmacy to receive plan benefits. We may not pay for your prescriptions
if you use an out-of-network pharmacy, except in certain cases. The pharmacies in our network can change at any time. You can ask for a current Pharmacy
Network List or search the Senior Health Plan provider directory on this website.
As a member of Senior Health Plan, you have the right to make complaints and to ask us to reconsider decisions we have made.
A complaint is also called a "grievance".
A coverage decision that involves your medical care is called an "organization determination".
When a coverage decision involves a Part D medication, it is called a "coverage determination".
When you ask us to reconsider a decision we made, it means you are asking for an "appeal".
To learn more, click on the links below.
Additionally, Senior Health Plan Member Services can help if you have any questions or concerns.